Glycemic Durability of Rosiglitazone, Metformin, or Glyburide Monotherapy

S Kahn; S Haffner; M Heise; W Herman; R Holman; N Jones; B Kravitz; J Lachin; M C O'Neill; B Zinman; G Viberti; ADOPT Study Group

doi:10.1056/NEJMoa066224

Glycemic Durability of Rosiglitazone, Metformin, or Glyburide Monotherapy

S Kahn, S Haffner, M Heise, W Herman, R Holman, N Jones, B Kravitz, J Lachin, M C O'Neill, B Zinman, G Viberti, ADOPT Study Group

King's College London

Research output: Contribution to journal › Article › peer-review

2694 Citations (Scopus)

Abstract

Background The efficacy of thiazolidinediones, as compared with other oral glucose-lowering medications, in maintaining long-term glycemic control in type 2 diabetes is not known. Methods We evaluated rosiglitazone, metformin, and glyburide as initial treatment for recently diagnosed type 2 diabetes in a double-blind, randomized, controlled clinical trial involving 4360 patients. The patients were treated for a median of 4.0 years. The primary outcome was the time to monotherapy failure, which was defined as a confirmed level of fasting plasma glucose of more than 180 mg per deciliter (10.0 mmol per liter), for rosiglitazone, as compared with metformin or glyburide. Prespecified secondary outcomes were levels of fasting plasma glucose and glycated hemoglobin, insulin sensitivity, and β-cell function. Results Kaplan–Meier analysis showed a cumulative incidence of monotherapy failure at 5 years of 15% with rosiglitazone, 21% with metformin, and 34% with glyburide. This represents a risk reduction of 32% for rosiglitazone, as compared with metformin, and 63%, as compared with glyburide (P

Original language	English
Pages (from-to)	2427 - 2443
Number of pages	17
Journal	New England Journal of Medicine
Volume	355
Issue number	23
DOIs	https://doi.org/10.1056/NEJMoa066224
Publication status	Published - 7 Dec 2006

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title = "Glycemic Durability of Rosiglitazone, Metformin, or Glyburide Monotherapy",

abstract = "Background The efficacy of thiazolidinediones, as compared with other oral glucose-lowering medications, in maintaining long-term glycemic control in type 2 diabetes is not known. Methods We evaluated rosiglitazone, metformin, and glyburide as initial treatment for recently diagnosed type 2 diabetes in a double-blind, randomized, controlled clinical trial involving 4360 patients. The patients were treated for a median of 4.0 years. The primary outcome was the time to monotherapy failure, which was defined as a confirmed level of fasting plasma glucose of more than 180 mg per deciliter (10.0 mmol per liter), for rosiglitazone, as compared with metformin or glyburide. Prespecified secondary outcomes were levels of fasting plasma glucose and glycated hemoglobin, insulin sensitivity, and β-cell function. Results Kaplan–Meier analysis showed a cumulative incidence of monotherapy failure at 5 years of 15% with rosiglitazone, 21% with metformin, and 34% with glyburide. This represents a risk reduction of 32% for rosiglitazone, as compared with metformin, and 63%, as compared with glyburide (P",

author = "S Kahn and S Haffner and M Heise and W Herman and R Holman and N Jones and B Kravitz and J Lachin and O'Neill, {M C} and B Zinman and G Viberti and {Study Group}, ADOPT",

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month = dec,

day = "7",

doi = "10.1056/NEJMoa066224",

language = "English",

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T1 - Glycemic Durability of Rosiglitazone, Metformin, or Glyburide Monotherapy

AU - Kahn, S

AU - Haffner, S

AU - Heise, M

AU - Herman, W

AU - Holman, R

AU - Jones, N

AU - Kravitz, B

AU - Lachin, J

AU - O'Neill, M C

AU - Zinman, B

AU - Viberti, G

AU - Study Group, ADOPT

PY - 2006/12/7

Y1 - 2006/12/7

N2 - Background The efficacy of thiazolidinediones, as compared with other oral glucose-lowering medications, in maintaining long-term glycemic control in type 2 diabetes is not known. Methods We evaluated rosiglitazone, metformin, and glyburide as initial treatment for recently diagnosed type 2 diabetes in a double-blind, randomized, controlled clinical trial involving 4360 patients. The patients were treated for a median of 4.0 years. The primary outcome was the time to monotherapy failure, which was defined as a confirmed level of fasting plasma glucose of more than 180 mg per deciliter (10.0 mmol per liter), for rosiglitazone, as compared with metformin or glyburide. Prespecified secondary outcomes were levels of fasting plasma glucose and glycated hemoglobin, insulin sensitivity, and β-cell function. Results Kaplan–Meier analysis showed a cumulative incidence of monotherapy failure at 5 years of 15% with rosiglitazone, 21% with metformin, and 34% with glyburide. This represents a risk reduction of 32% for rosiglitazone, as compared with metformin, and 63%, as compared with glyburide (P

AB - Background The efficacy of thiazolidinediones, as compared with other oral glucose-lowering medications, in maintaining long-term glycemic control in type 2 diabetes is not known. Methods We evaluated rosiglitazone, metformin, and glyburide as initial treatment for recently diagnosed type 2 diabetes in a double-blind, randomized, controlled clinical trial involving 4360 patients. The patients were treated for a median of 4.0 years. The primary outcome was the time to monotherapy failure, which was defined as a confirmed level of fasting plasma glucose of more than 180 mg per deciliter (10.0 mmol per liter), for rosiglitazone, as compared with metformin or glyburide. Prespecified secondary outcomes were levels of fasting plasma glucose and glycated hemoglobin, insulin sensitivity, and β-cell function. Results Kaplan–Meier analysis showed a cumulative incidence of monotherapy failure at 5 years of 15% with rosiglitazone, 21% with metformin, and 34% with glyburide. This represents a risk reduction of 32% for rosiglitazone, as compared with metformin, and 63%, as compared with glyburide (P

U2 - 10.1056/NEJMoa066224

DO - 10.1056/NEJMoa066224

M3 - Article

SN - 1533-4406

VL - 355

SP - 2427

EP - 2443

JO - New England Journal of Medicine

JF - New England Journal of Medicine

IS - 23

ER -

Glycemic Durability of Rosiglitazone, Metformin, or Glyburide Monotherapy

Abstract

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